Alyssa Taylor McCormick, BSW,MSW, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P014507 Issued in NC

Practice address

2935 Breezewood Ave Ste 103
Fayetteville, NC 28303-5498

Phone

(910) 491-1758

NPI assigned

Apr 16, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Second Chance Counseling Services, PLLC

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1801308143
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1669092904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6916 BROCKWOOD ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145303",
            "telephone_number": "910-644-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 BREEZEWOOD AVE STE 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035498",
            "telephone_number": "910-491-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "ALYSSA",
        "middle_name": "TAYLOR",
        "credential": "BSW,MSW, LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada McCollum
• Tamika McCollum, LCMHCA
• Ezra Lee McConnell III, M.D.
• Jane M McConnell, M.D.
• Sara Ranea McConnell, LCMHCA
• Araina McCormick
• Azyion McCormick
• Kristin McCormick, PT
• Mayla McCormick
• Erin J McCoy, OTRL

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.